Australia will become the first country in the world to introduce a tough new system to protect patients from medical professionals who have been accused of sexual misconduct.

An independent review has found the current system is outdated, paternalistic, fails to meet community expectations and should be abandoned.

Previously, chaperones supervising doctors under investigation while they treated patients were not required to be trained medical professionals, and doctors did not have to explain to patients why they were used.

Under the new arrangements, patients would have more information on why a doctor was under supervision and chaperones would be replaced by "practice monitors" with medical training who were not paid directly by the doctor.

It was triggered by the case of Andrew Churchyard, a Victorian neurologist who was accused of molesting a number of patients before taking his own life last year.

Tom Monagle was 19 when he was allegedly twice sexually assaulted by Dr Churchyard during routine medical examinations.

The Medical Board of Australia and the Australian Health Practitioner Regulation Agency (AHPRA) commissioned the report last August, and it was released today.

Abuse of trust leads to long-term harm

Its author, Professor Ron Paterson, is an internationally recognised expert on patient safety.

He conducted extensive consultation with the community and profession, as well as receiving submissions from patients, health practitioners, colleges and professional organisations, abused patients and chaperoned doctors.

He also looked at the use of chaperones in the United Kingdom, Canada, the United States and New Zealand.

"Patients do not know and should not expect a health consultation to be a place where they may be indecently assaulted or subjected to a sexual advance," Professor Paterson said.

"They trust doctors never to use patients for their own sexual gratification. When their trust is abused, patients suffer major long term harm ... changes are needed to better protect patients."

About 35 doctors in Australia are currently subject to chaperoning.

"Their use is largely confined to private medical practice, the system relies on inadequately informed and trained chaperones, many in a conflicted situation by being employed by the practitioner they are to observe and report on," Professor Paterson said.

"There are many reported examples of practitioners breaching chaperone conditions.

"Predatory practitioners who have come to view patients as sexual objects may not be deterred by a safety mechanism that still leaves the practitioner in control."

Professor Paterson said the most significant flaw in the system was lack of information for patients.

"The chaperone system keeps patients in the dark, they do not know why a chaperone is required," he said.

"In theory there's a sign but the signs are often very hard to read. And patients came forward during this review and said 'oh I thought it was just somebody there for training purposes'."

Compelling case for change

He said different disciplinary measures were imposed by different states, and delays in finalising investigations were stressful and unfair to both patients and practitioners.

Professor Paterson made 28 recommendations which have been adopted by the Medical Board of Australia and AHPRA including:

Chaperones will no longer be used except in exceptional cases and will be called "practice monitors" and when they are used, monitoring of doctors will be stepped up and patients will receive more information

A specialist national team will be established and trained to improve handling of sexual misconduct complaints

Medical authorities have written to all police departments to establish inter-agency protocols

Authorities are reviewing doctors currently being monitored by chaperones.

Chair of the Medical Board Joanna Flynn said the report made a compelling case for change.

"We are making big changes to the way we deal with concerns about sexual boundary violations," Dr Flynn said.

"The recommendation is the practice monitor should be a registered health practitioner for two reasons.

"One is they have an accountability themselves in terms of their professional responsibilities to their registration board and secondly they have a better capacity to understand whether an examination that's being done, or a line of questioning is appropriate in the circumstances or may be being done for some other purpose for the doctor's gratification."

Dr Flynn also thanked the patients and families who came forward and shared their harrowing experiences.

"I'd like to particularly acknowledge Tom Monagle, and his mother [who spoke out about the abuse allegedly inflicted on him by Dr Churchyard]," she said.

"Their courage in speaking out led directly to this review which is leading to substantial regulatory reform."

Mr Monagle's mother Sharon Monagle, who is a doctor herself, said the review had gone far beyond her expectations.

"My feeling is that doctors really should embrace these changes because it really is in the interests of us, as individual practitioners and as a professional group, that poor performing doctors, who are very much a minority, are identified are taken out of practice quite swiftly to protect the public," she said.

"I think to do anything else really undermines all of our credibility."